Dean's Blind Spot

Maybe one reason former Vermont Gov. Howard Dean and so much of the digital Left can so casually dismiss the Senate health care reform bill is that they operate in an environment where so few people need to worry about access to insurance.

The 2004 presidential campaign that propelled Dean to national prominence was fueled predominantly by "wine track" Democratic activists-generally college-educated white liberals. (In the virtually all-white 2004 Iowa caucus, for instance, exit polls showed that two-thirds of Dean's votes came from voters with a college degree.) Those are the same folks, all evidence suggests, who provide the core support for online activist groups like MoveOn.org or Dean's Democracy for America and congregate most enthusiastically on liberal websites. (According to studies by the Pew Internet & American Life Project, college graduates are more than twice as likely as those with only a high-school degree to communicate about politics online.) Along with Dean, those digital Democratic activists are generating the loudest demands to derail the Senate bill.

Some individuals in these overlapping political networks undoubtedly
face challenges with access to health care, but as a group
college-educated whites are much less likely than any other segment of
the population to lack health insurance.

The latest annual Census Bureau figures show that in 2008 just 5.96
percent of college-educated whites lacked health insurance. For whites
without a college education, the share without insurance jumps to 14.5
percent (the number is surely higher for non-college whites who are not
union members). Among African-Americans, the share of those without
insurance rises to 19.1 percent. Among Hispanics, the share of those
without insurance soars to a daunting 30.7 percent, the Census found.

In his Washington Post op-ed Thursday, Dean wrote: "I know health care
reform when I see it, and there isn't much left in the Senate bill."
Yet the bill that Dean so casually dismisses would spend, according to
the Congressional Budget Office, nearly $200 billion annually once it
is fully phased in to help subsidize insurance coverage for over 30
million Americans now without it. That's real money--the most ambitious
and generous expansion of the public safety net since the Great Society
under Lyndon Johnson. And that money, based on the Census results,
would flow most into minority and working-class white communities.

Minorities don't seem to have much doubt about their investment in this
debate. In November's Kaiser Family Foundation health care tracking
poll, two-thirds of non-white Americans said that their family would be
better off if health care reform passes. Though the evidence suggests
that non-college whites could also receive a disproportionate share of
the bill's spending (since they constitute more of the uninsured), they
are dubious: just one-third of them believe they would be better off, a
reflection of the mounting skepticism about government such blue-collar
whites are expressing across the board. Yet the most skeptical group is
the college-educated whites, the same constituency that has the most
access to health insurance today: only about one-fourth of them expect
to be better off under reform.

Against the backdrop of those attitudes, it's instructive to compare
Dean's blithe disregard for the Senate bill to the more measured and
sensible tone that Andy Stern, president of the Service Employees
International Union, struck when he held a teleconference Thursday to
discuss the debate. Stern recapitulated the concerns that many on the
Left hold about the bill--the adequacy of the subsidies for the
uninsured, the bite of the "Cadillac" tax on high-end insurance plans.
But Stern also insisted: "We can't just focus on what we don't
like--it's the largest expansion of coverage since Medicare, it's the
largest expansion in Medicaid; with the bill it would make things way
better than what our current system does, for our members at least."

Stern didn't commit to endorsing the final bill, but he pointedly
refused to join Dean in urging the Senate to tear up its work. Stern
can't surrender to the vanity of absolutism because he represents a
predominantly lower-income and minority constituency with a tangible
stake in the outcome of this epic legislative struggle--not only for
themselves but for their relatives, neighbors and friends. For much of
the constituency that Dean and the digital Left represent, by contrast,
the health care debate may be largely an abstraction--just another
round in their perpetual struggle to crush Republicans and
ideologically cleanse the Democrats.

No president has ever come as close as Barack Obama is today to moving
the nation toward universal health coverage; no universal coverage bill
had ever before passed the House, nor has one ever advanced as far in
the Senate as the bill now under debate. For Dean to insist that Senate
Democrats start over after that grueling struggle is a little like
suggesting that American troops on the outskirts of Berlin in 1945
should have retreated back to France because D-Day wasn't choreographed
just right.

The broad mass of college-educated white voters are an increasingly
central component of the Democratic coalition. But it remains a
challenge for the party to manage the expectations of that community's
most liberal segments because they tend to see politics less as a means
of tangibly improving their own lives than as an opportunity to make a
statement about the kind of society they want America to be. That is
not a perspective that encourages compromise or pragmatism. It may be
easier for Dean, and the activists cheering him on, to view the Senate
bill as an affront to their values precisely because so few of their
interests are directly at stake in the fierce fight over this imperfect
but landmark legislation.

Ronald Brownstein, a two-time finalist for the Pulitzer Prize for his coverage of presidential campaigns, is Atlantic Media's editorial director for strategic partnerships, in charge of long-term editorial strategy. He also writes a weekly column and regularly contributes other pieces for the National Journal, contributes to Quartz, and The Atlantic, and coordinates political coverage and activities across publications produced by Atlantic Media.